Efficacy of Racecadotril in acute diarrhea in children: systematic review of the literature and meta-analysis of randomized clinical trials

Introduction: Acute diarrhea in children is a common disease. Standard treatment is oral rehydration, but antidiarrheal drugs are still widely used. However, their efficacy is debated: several trials and meta-analyses show results that are sometimes contradictory, but often reach the same conclusions : generally, the results are significant, but with a low level of evidence. Objective : The aim of this study was to evaluate the efficacy of Racecadotril in acute diarrhea in children, through a systematic literature review and meta-analysis of randomized trials, using the REB method. Method : A bibliographic search was conducted for articles published until 10/02/2023. The risk of bias was assessed using the RoB2 tool. The endpoints were duration of diarrhea, stool production and length of hospitalization. The REB method was used to assess the overall level of evidence of efficacy. Results : 5 trials were selected and included 904 patients. The conclusion was the absence of evidence of effect on the three endpoints. Conclusion: This study shows that there is no solid evidence that the three drugs are effective in treating acute diarrhea in children, but new randomized trials of good methodological quality could provide more significant results.